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Indications

Zenifol is indicated in-
  • Prophylaxis and treatment of Iron deficiency anaemia in pregnancy.
  • Prevention of megaloblastic anaemia of pregnancy.

Pharmacology

Iron is an essential constituent of the body being necessary for haemoglobin formation and for the oxidative processes of living tissues. Iron salts should only be given for the treatment and as prophylaxis of Iron deficiency anaemia. Iron deficiency anaemias are most often the result of chronic haemorrhage, nutritional deficiency, pregnancy or parasite infestation or malabsorption of iron.

A deficiency of Folic acid typically during pregnancy has long been known to cause a megaloblastic anaemia. The vitamin is not storable in the body and the combination of fetal demand during pregnancy and malnutrition can lead to a deficiency, hence anaemia. It has been observed that the rapid production of red blood cells following treatment with iron may deplete body folate if there is inadequate intake; combination of folic acid and ferrous fumerate avoids the complication. Iron and Folic acid are absorbed in the proximal small intestine particularly the duodenum. Ferrous Fumerate & Folic acid supplements replenish iron deficiency. Thereby arresting the anaemia process. Absorbed iron is taken upto the bone marrow's tissues that form blood cells where it is used to synthesize haemoglobin.

Dosage & Administration

Adults: One tablet daily. When necessary one tablet may be given twice daily. In pregnancy, it is recommended that Irolic tablet should be started at first antenatal consolation and continues for 3 months after delivery. The tablet should preferably be taken before meals; if there are gastro-intestinal disturbances, doses may be taken after meals.

Interaction

The absorption of iron salts and tetracycline is diminished when they are taken concomitantly by mouth. If treatment with both drug is required, the iron salt should be administered 3 hours before or 2 hours after the tetracycline. The absorption of iron salts is also decreased in the presence of antacids or when taken with tea. Iron salts appear to reduce the effects of penicillamine. Co-trimoxazole may inhibit megaloblastic haemopoiesis. Serum anticonvulsant levels may be reduced by administration of folate.

Contraindications

This is contraindicated in patients with pernicious anaemia and anaemia other than those due to iron deficiency. The nature and causes of anaemia should be established. Absorption of Ferrous Fumerate & Folic acid is inhibited by Magnesium trisillicate and Antacid containing carbonate.

Side Effects

Side effects of iron and folic acid preparations which have been reported include nausea, vomiting, gastro-intestinal symptoms, constipation and diarrhea.

Precautions & Warnings

Administration of Irolic during the first trimester of pregnancy may be undesirable. Very few pregnant women are not protected by physiological doses of folic acid. If anaemia is developed despite prophylaxis with Irolic, patient should be investigated further. Some post-gastrectomy patient show poor absorption of Fe. Care is needed when treating patients with peptic ulcer.

Overdose Effects

Patients who have taken an overdose should have gastric lavage performed, if possible within four hours of the overdosage occurring. In addition patients should have such symptomatic treatment as appears necessary. In order to eliminate excess free iron, a chelating agent such as desferrioxamine should be administered as soon as possible. Giving milk and/or 5% solution of sodium bicarbonate by mouth will be helpful in the meantime.

Therapeutic Class

Iron & Vitamin Combined preparations

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.